carbamazepine-medication-template

ACTIVE LEARNING TEMPLATE: PURPOSE OF MEDICATION Expected Pharmacological Action Complications Contraindications/Precautions Interactions Medication Administration Evaluation of Medication Effectiveness Therapeutic Use Nursing Interventions Client Education Carbamazepine anticonvulsant/mood stabilizer Decreases synaptic transmission in the CNS by affecting sodium channels in neurons -IV route should only be used when oral route is not possible -PO (adults and children over 12): 200 mg- 800 mg BID -PO (children under 12): range depends on weight -IV (Adults): total daily dose is 70% of oral dose -Take with food Nefazone or NNRTIs, MAO Inhibitors: decrease efficiency of carbamazepine May decrease efficiency of MANY drugs Grapefruit juice: increased serum levels and oral bioavailability Contra: hypersensitivity to tricyclic antidepressants or carbmazepine, bone marrow suppression, concomitant use or use within 14 days of MAO Inhibitors, moderate to sever renal impairment, OB (risk vs benefit), lactation Precaution: All patients (increased risk of suicidal thoughts), cardiac or hepatic disease, renal failure, increased intraocular pressure, pedi, geri suicidal thoughts, ataxia, drowsiness, fatigue, psychosis, sedation, vertigo, blurred vision, nystagmus, pneumonitis, HF, edema, heart block, hypertension, hypotension, syncope, liver failure, pancreatitis, weight gain, urinary retention, DRESS, Stevens-Johnson Syndrome, nail shedding, agranulocytosis, aplastic anemia, thrombocytopenia Prevention of seizures. Relief of pain in trigeminal neuralgia. Decreased mania. -Monitor for changes in skin integrity, suicidal ideation -Monitor for s/s of Stevens-Johnson Syndrome -Assess for seizures - CBC, platelet/reticulocyte count and serum iron at baseline -Monitor ECG, AST, ALT, BUN -Absence of seizures or reduction of seizure activity; decrease trigeminal neuralgia pain. Patients with trigeminal neuralgia who are pain free should be reevaluated every 3 months to determine minimum effective dose; decreased mania and depressive symptoms in bipolar I disorder -Take medication around the clock as directed, do not double doses, notify HCP if more than one dose is missed, discontinue slowly -Do not drink grapefruit juice or eat grapefruit -Advise patient to get up slo